Successful use of spesolimab in refractory pyoderma gangrenosum

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis that typically begins as a painful erythematous papule or pustule and rapidly progresses to ulceration and necrosis, often with irregular, violaceous, undermined borders. PG is frequently associated with underlying systemic disease and autoimmune diseases such as rheumatoid arthritis and ulcerative colitis and can develop following minor trauma—a phenomenon known as pathergy.1 Because of this, misdiagnosis as a nonhealing ulcer can have serious consequences, as debridement may exacerbate the disease due to this pathergic response.